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Etiologies, risk factors, and outcomes of bacterial cholangitis after living donor liver transplantation

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The interpretation of bacterial cholangitis after liver transplantation (LT) remains vague, because the presence of bacteria in bile, namely bacteriobilia, does not necessarily indicate an active infection. We investigated the association between post-LT bacterial cholangitis and a variety of short- and long-term outcomes. Two-hundred-seventy-four primary adult-to-adult living donor LT recipients from 2008 to 2016 were divided into three groups according the presence or absence of bacteriobilia and clinical symptoms: (1) no bacteriobilia (N group), (2) asymptomatic bacteriobilia (B group), and (3) cholangitis (C group). The number of patients was by group: N, 161; B, 64; and C, 49. Donor age ≥ 45 years (p = 0.012), choledochojejunostomy (p < 0.001), and post-LT portal hypertension (p = 0.023) were independent risk factors for developing cholangitis. Survival analysis revealed that the C group had significantly worse short- and long-term graft survival. The C group was associated with an increased incidence of early graft loss (EGL) (p < 0.001). While the frequency of readmission for recurrent cholangitis was significantly higher in both the B and C groups (p < 0.001), late graft loss (LGL) due to chronic cholangitis was only commonly observed in the C group (p = 0.002). Post-LT cholangitis could result in not only EGL but also chronic cholangitis and associated LGL.

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Acknowledgments

The authors are grateful to the members of the infection control team (ICT) in Kyoto University Hospital.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Siyuan Yao, Shintaro Yagi, Sena Iwamura, Yosuke Miyachi, Hisaya Shirai, Atsushi Kobayashi, Shinya Okumura, Yuhei Hamaguchi, Yuuki Masano, Toshimi Kaido, Hideaki Okajima & Shinji Uemoto

  2. Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan

    Miki Nagao

  3. Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Ryuji Uozumi

  4. Department of Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Japan

    Taku Iida

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  1. Siyuan Yao
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  2. Shintaro Yagi
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  3. Miki Nagao
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  4. Ryuji Uozumi
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  6. Sena Iwamura
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  7. Yosuke Miyachi
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  8. Hisaya Shirai
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  11. Yuhei Hamaguchi
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  13. Toshimi Kaido
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  14. Hideaki Okajima
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  15. Shinji Uemoto
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Correspondence to Shintaro Yagi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yao, S., Yagi, S., Nagao, M. et al. Etiologies, risk factors, and outcomes of bacterial cholangitis after living donor liver transplantation. Eur J Clin Microbiol Infect Dis 37, 1973–1982 (2018). https://doi.org/10.1007/s10096-018-3333-4

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  • DOI: https://doi.org/10.1007/s10096-018-3333-4

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